Model of Group Therapy: Essential when the client is a child

Leading a group can be a very daunting and intense experience. To make matters worse, many leaders are either unprepared, under skilled, or under-educated about group dynamics and it’s processes. While there are numerous resources outlining these conditions for work with adults, very little materials cover work with children or adolescents, especially when working with child victims of abuse. The purpose of this article is to provide a brief and basic summary of an appropriate group model for use when working with abused children within an open enrollment, agency setting.

It is imperative that one understands that as a group leader of children participants, he or she must use the leader-directed or oriented approach. Jacobs, Masson and Harvill (2009) suggest that children’s group leaders be prepared “to take on more responsibility for the group than in a group composed of adults,” (p. 399) as children will not usually come to group ready to discuss a particular topic nor will they be inclined to stay on topic if not directed. Additionally, a substantial portion of any children’s group will include an education component, whether that be regarding the importance of self-esteem, anger management, or general safety planning to reduce the likelihood that a child be further victimized, it will be the leader’s responsibility to present this information. It is therefore necessary that this leader understand each child’s needs and structure group focus to meet those needs, (Lantz, 2001).

As with any other type of group, it is important that each session be structured with a beginning, middle, and closing phase. When working with child clients, particularly in an open enrollment type group, it is necessary to formally engage the children in the beginning stage. Introducing new students, reiterating the group purpose, and acknowledging the commonality that all the participants share will aide in the effectiveness of the group in two ways; (1) this will allow the “new” child to begin feeling comfortable, safe, and sense of belonging, and (2) reinforce the effectiveness, commonality, and focus to the “seasoned” participants. This phase should be no longer than 10 minutes, otherwise the leader risks the chance that the children will become bored and thus engaging in alternative activities that will deter from the order of the group.

The middle phase will contain the depth of the discussion and topic for the day. In the leader-directed approach, he or she will be responsible for providing information and educating the children on the chosen topic. Structured group activities should also be intermingled with lecture, as attentions can easily wane. Hands-on activities, will enhance the the group as they have been shown to be tremendously effective at keeping the child client focused on the topic, (Jacobs, Masson & Harvill, 2009) and broadening their depth of understanding. While the goal in working with children groups is to maintain a singular focus, it is sometimes necessary to shift if, as a leader, one recognizes a disconnect or a child’s inability to attend to the topic. Continued attempts to persevere will surely end in the children becoming disruptive, resentful, and tuning out to the topic. Again, as a children’s group leader, it is necessary to be observant and gain an understanding of each participants needs in order to remain beneficial to the clients.

The final phase is just as important as it’s counterparts. This phase allows for the child client to process those feelings that surfaced as result of group, gain a sense of closure, and participate in the ending rituals of the group. The final phase can include several techniques such as: relaxation breathing, songs, or a movement activity. Often times, leaders will impart food into their final phase. Kaduson (2006) maintains that food is beneficial in two ways, “it provides an effective form of tangible nurturance,” (p.251) thus reinforcing that group is a safe and caring place, and “second, snack time parallels a family meal in ways that often facilitate treatment….. just as shared meals help strengthen bonds within functional families, snack times provide the group members with opportunities to process issues, talk through problems, share feelings, and resolve conflicts together,” (p. 251).Which ever method is used, is important to remember that the “ritual” of this phase is important to facilitate the continued growth of the group, (Kaduson, 2006) and that it should be employed at every session, (Jacobs, Masson & Harvill, 2009).

It is crucial that one does not undervalue their work as a group leader or the value that group therapy can provide for the child participants. Authors such as Shechtman (2004), in addition to many other professionals, agree that group therapy and interventions instilled therein are quite effective when working with children. And “for some children, groups can be much better than individual counseling because groups allow children a place to learn and practice new skills,” (Jacobs, Masson & Harvill, 397). While this article serves to provide the reader with only a brief summary of a group model used with children, the phases and formation of rituals should be considered quite heavily when planning such groups. Kaduson (2006) finds that an emphasis needs to be placed on predictability when working with children, as this experience leads to a naturally occurring sense of safety and order within the group. Likewise, “beginning and ending rituals contribute to the establishment of trust and security, as anxiety is reduced when children can anticipate what will happen,” (p. 250).
Stephanie Henckel

References

Jacobs, E., Masson, R. & Harvill, R. (2009). Group counseling; Strategies and skills (6th ed.). ThomsonBrooks/Cole. Belmont, CA.
Kaduson, H. (2006). Short-term play therapy for children (2nd ed.). Guilford Publications, Inc. New York, NY.
Lantz, J. (2001). Play time: An examination of play intervention strategies for children with autism spectrum disorders. The Reporter, 6(3), 1-7, 24.
Shechtman, Z. (2004). Group counseling/psychotherapy with children. The Group Worker, 32(3), 7-9.